Working During COVID: FiY1 Perspective

Written by Dr Liandra Ramachenderam FY1 Doctor

I’m Liandra, an F1 currently working in the East Anglian region. When I was told that as a final year student from the University of Birmingham, that I would be offered an interim job, I imagined being in the frontline or at least in an acute medical ward dealing with patients with COVID however, I was given an offer to work as a FiY1 in an acute psychiatric ward. This initially baffled me because I truly felt at that time that I could be of more help in other areas at this unprecedented time. However, when I started, I quickly realised that all foundation doctors working in psychiatry in my region had been redeployed to work in acute medical settings and it became clearer why they needed me there.

Prior to my arrival in June, the ward was a COVID ward which meant that all positive patients across the psychiatric trust were sent to our ward and our patients were moved across the board, however, just as I arrived changes had been made and we turned back into an acute ward. This meant that all new admissions were being referred to us which led to over 40 patients being admitted onto our ward over a period of a month, far more than they have ever had.

This may seem like an insignificant number at first but this was an indication to me of the large effect this pandemic has had on mental wellbeing, in particular those with a pre-existing mental health illness. The major reason for this was the collapse in their support system and the difficulty for these patients to access care. They were no longer able to go to their support

groups, social workers were no longer visiting them at home and detecting self-neglect and difficulties they were having with there mental health was not being treated as effectively as virtual consultations often did not work for them so they struggled at home until they reached a breaking point which led their admissions.

The challenges that we faced included ill-equipped facilities in a psychiatric hospital that did not enable isolation and social distancing. Patients were so acutely unwell that they were not able to comprehend what it even means to socially distance from one another and trying to explain to manic and psychotic patients why we were all in a mask in a way that did not fuel their pre-existing paranoid thoughts was extremely difficult.

Despite this, we saw our patients’ mental health improve and so many of them were well enough to be discharged. Looking back on that time I don’t think we would have gotten through this without the camaraderie, teamwork, kindness and good communication between all allied healthcare professionals in the patient’s care and this makes me feel so privileged to have been part of this team and I cannot think of a better way to start my career as a doctor.